Medicare Advantage – Page 49 – medicarereport.org

A trusted source for Medicare news and education from the AMAC Foundation.

The current Medicare Advantage payment structure results in overpayments

Current research states that the millions of beneficiaries in traditional Medicare who have switched to Medicare Advantage plans have lower

Eileen Cook June 14, 2023June 14, 2023 Healthcare Finance, Healthcare Reform, medicare, Medicare Advantage, Medicare Advantage Overpayments

Legal Actions/Court Decisions Medicare Advantage

NYC declines to enact Aetna Medicare Advantage plan, citing ongoing lawsuit

(By Rylee Wilson for Becker’s Hospital Review ) New York City’s comptroller is halting implementation of an Aetna Medicare Advantage

Eileen Cook June 12, 2023June 12, 2023 Aetna, Medicare Advantage, NYC Retirees

DHS -OIG Health Care Finance Medicare Advantage

6 Medicare Advantage plans audited for upcoding in the last six months

(By Rylee Wilson for Becker’s Hospital Review ) Audits published in the last six months found almost $32 million in

Eileen Cook June 9, 2023June 9, 2023 DHS -Office of Inspector General, Healthcare Finance, Medicare Advantage, Medicare Advantage Overpayments, Upcoding

CMS Health Care Finance Medicare - General Medicare Advantage Part D/Prescription Drugs

The Facts About Medicare Spending

(Source - The Kaiser Family Foundation Published June 2023) Medicare provides health insurance coverage for more than 65 million people,

Eileen Cook June 8, 2023June 8, 2023 Aging Population, CMS, Healthcare Finance, medicare, Medicare Advantage, Medicare Part D, Older Adults

Aging Health Care - General Hospice/Home Health Services Medicare Advantage

Optum home care program linked to fewer emergency, hospital visits for Medicare Advantage members: Study

(By Jakob Emerson for Becker’s Hospital Review ) Medicare Advantage patients who receive in-home health visits through the Optum HouseCalls

Eileen Cook June 8, 2023June 8, 2023 Home Care, Medicare Advantage, Older Adults, Optum HouseCalls program

Legal Actions/Court Decisions Medicare Advantage

Retirees challenging New York City’s Aetna Medicare Advantage plan in court

(By Rylee Wilson for Becker’s Hospital Review ) A group of retired New York City employees are suing Mayor Eric

Eileen Cook June 1, 2023June 1, 2023 Lawsuit, Medicare Advantage, New York City Retirees, New York County Supreme Court

CMS Health Care Finance Medicare Advantage

Medicare Advantage star ratings decline will cost CVS Health up to $1B in revenue

(By Jakob Emerson for Becker’s Hospital Review ) CVS Health is expecting Aetna’s operating income to decrease by up to

Eileen Cook May 30, 2023May 30, 2023 Aetna, CMS, CVS Health, Healthcare Finance, Medicare Advantage, Medicare Advantage Star Ratings

CMS Medicaid Medicare - General Medicare Advantage Mental Health/Behavioral Health

CMS: Dual-eligible Medicare Advantage members less likely to receive cancer screenings, mental healthcare

(By Rylee Wilson for Becker’s Hospital Review ) Individuals who are dually eligible for Medicare and Medicaid had lower scores

Eileen Cook May 25, 2023May 25, 2023 Cancer Screenings, CMS, Dual Eligible, Medicaid, medicare, Mental Health

Medicare - General Medicare Advantage

6 recent Medicare Advantage study findings

(By Rylee Wilson for Becker’s Hospital Review ) Medicare Advantage and traditional Medicare can differ on clinical quality and costs,

Eileen Cook May 23, 2023May 23, 2023 Cost and Quality, medicare, Medicare Advantage

CMS Legislative Update Medicare Advantage

Senators probing largest Medicare Advantage plans over how algorithms factor in care denials

(By Bob Herman and Casey Ross for ST A T) Senators warned the country’s largest Medicare Advantage insurers at a

Eileen Cook May 18, 2023May 18, 2023 Algorithms Factor, Care Denials, CMS, Medicare Advantage, Medicare’s Coverage rules